Measles: How Scared Do You Need To Be?

It is easy to catch measles by inhaling the droplets or touching your face, mouth, nose or eyes after touching contaminated surfaces. So remember proper hand hygiene is critical to your protection of both measles but is also good practice to prevent common colds and other viruses.

It looks like measles is here to stay, with several outbreaks already reported this year, including in Alberta and most recently in California. The measles outbreak at Disneyland has caused panic among many parents and those that work in health care. There are least 80 confirmed infections and concern builds that the virus may cross borders given the appeal of Disneyland as a popular family destination.

I am asked by well-meaning parents daily about how to protect their child from measles. Some of these parents have vaccinated their children, and some have not. I suspect that with the growing numbers of unvaccinated children the numbers of cases of measles each year will rise.

What is measles?

Measles is caused by a virus commonly active in the winter and spring. It is passed on through contaminated droplets spread in the air and on nearby services where they land. It is easy to catch measles by inhaling the droplets or touching your face, mouth, nose or eyes after touching contaminated surfaces. So remember proper hand hygiene is critical to your protection of both measles but is also good practice to prevent common colds and other viruses.

What does it look like?

Measles usually begins with a fever that is followed by conjunctivitis (pink eye), and nasal congestion. The rash usually starts on the face and upper back and spreads down the body towards the toes. When it fades it fades in the same order that it appeared.

How contagious is it?

Very. In fact, it floats in the air. You can infect someone else standing 100 feet away!

Measles is very contagious. Measles is contagious even four days before the rash starts and four days after the rash is gone. The measles virus lives in the mucus in the nose and throat, therefore when the child sneezes or coughs it spreads into the air. Your child is more likely to develop measles if they have not been vaccinated, have a weak immune system or you are traveling to countries where vaccination is less common.

Why do we worry about a seemingly benign infection?

Most children that get measles do well with minimal illness. However having measles does increase your risk for ear infections, pneumonia and diarrhea. Rarely children can develop encephalitis, inflammation of the brain. Though death from measles is uncommon, it can happen. As a doctor, and mom of a newborn, I am most concerned that unvaccinated children will pose a risk to kids that are not able to receive the vaccination due to immune problems, and are too young to get vaccinated (kids less than one year). Of course, being younger or immunocompromised puts these children at higher risk of serious infection and death.

How to make the diagnosis?

If your child is not vaccinated with the measles, mumps, rubella vaccine (MMR), they are at risk of being infected with measles. If you are concerned about measles infection, please see your doctor. Your doctor may order blood tests or viral swabs from the nose or throat. Before you see your doctor please inform him or her that your child may have contracted measles. This will ensure that your child is not exposed to children with weak immune systems or babies who have not yet been vaccinated.

Can we treat it?

Because measles is a virus, there is no specific treatment. We provide supportive care that includes drugs to manage the fever (acetaminophen, ibuprofen), fluids and plenty of rest.

How can I protect my child from measles infection?

The best way to protect your child from measles is through vaccinating with the MMR Vaccine. This vaccine is given at one year and a booster given at 4-6 years of age. One vaccine dose provides 95 per cent protection, two doses increases this to 99 per cent.

Avoidance of children that are not immunized, who are risk of infection with measles can also help prevent spread. But, measles is contagious even before the symptoms appear, so it is hard to know who is 'at risk'.